Asthma guidancePosted on: 19 Feb 2018
At the present time, there are multiple conflicting UK asthma guidelines. The Scottish Intercollegiate Guidelines Network (SIGN) and British Thoracic Society (BTS) published their guideline on asthma management in September 2016. Subsequently, in November 2017 NICE published their own guideline on diagnosis, monitoring and chronic asthma management.
Discrepancies between the two guidelines have the potential to introduce uncertainty for clinicians and inconsistencies in patient care. Resolution has been provided, for both primary care practitioners and commissioners, in ‘Asthma Guidelines in Practice – a PCRS-UK Consensus’ (Part 1). This was written by Luke Daines (GP and Academic Clinical Fellow, University of Edinburgh) alongside various GP and nurse colleagues.
For the most part, the Consensus supports the BTS/SIGN position on diagnosis, and reasserts the importance of clinical investigation and regular assessments. In line with NICE, it recommends investigating the creation of diagnostic hubs to provide diagnostic services not presently available in primary care.
As regards treatment, it accepts the cost-benefit rationale for leukotriene receptor antagonists as add-on treatment after low-dose inhaled corticosteroids.
The authors call for collaboration between NICE and BTS/SIGN in developing a single asthma guideline. This view is further elaborated by Noel Baxter and Duncan Keeley in an article recently published in the BMJ, entitled ‘Conflicting asthma guidelines cause confusion in primary care’ (Part 2).
You can watch two clinicians discussing the similarities and discrepancies between the guidelines in our video.